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Curriculum

Pulmonary Pathology fellows and faculty use microscopes to look at slides.

Clinical training

The clinical rotations occur mainly at Mayo Clinic's campus in Scottsdale, Arizona, though you have the opportunity to spend up to two months at Mayo Clinic's campus in Rochester, Minnesota.

Due to the breadth and volume of cases, you will be exposed to all areas of thoracic pathology, including neoplastic and non-neoplastic diseases of the lung, pleura, and mediastinum. This occurs through review of in-house specimens, consultation cases received in our large referral practice (which averages 3,500 to 4,000 thoracic specimens a year), and review of the Charles B. Carrington Memorial Teaching Collection (one of the largest curated collections of thoracic pathology cases in the world containing over 30,000 cases). One month will be spent rotating on our busy cytopathology service, where you will see samples obtained by endobronchial ultrasound (EBUS) and help provide rapid on-site assessment of samples. 

Interactions between chest radiologists and pulmonary pathologists allow you to gain extensive experience in radiologic-pathologic correlation for both neoplastic and non-neoplastic thoracic disease. Our pulmonary medicine physicians will also be a rich source of information for clinical correlation with pathology specimens.

To complement the clinical material in Arizona, you will also have the opportunity to rotate at Mayo Clinic's campus in Rochester, Minnesota. Such rotations may include the fluorescence in situ hybridization (FISH) and molecular pathology laboratories to familiarize yourself with the various molecular tests performed on lung cancers, as well as the general pulmonary pathology service. 

Your responsibility is gradually increased over the training period, such that by the end of the fellowship, you are responsible for the initial case work-up and final conversations with referring pathologists. 

Because different fellows have different career goals, the curriculum allows for electives and opportunities to explore diverse areas of pathology that may complement pulmonary pathology or fulfill the needs of a future job or practice. Therefore, fellows may rotate in areas such as cardiovascular pathology, frozen section service, bone and soft tissue pathology, hematopathology, and others.

Rotation schedule

The curriculum is divided into 13 four-week blocks. Nine blocks are dedicated to pulmonary pathology and the consultation practice, which may include rotations at Mayo Clinic's campus in Rochester, Minnesota. One block is dedicated to cytology and another to general surgical pathology. Dedicated research time is also incorporated into the schedule.

You will have two additional blocks that are electives, in which you can choose from many different areas of pathology to complement knowledge in thoracic pathology, prepare for a future job, do research, or complete more pulmonary rotations. We allow for flexibility to tailor to your career goals.

Conferences

There are multiple interdisciplinary conferences with pulmonologists, surgeons, and radiologists including:

  • Thoracic Tumor Board (weekly)
  • Pulmonary Medicine Case Conference (bi-monthly)
  • Interstitial Disease Conference (bi-monthly)
  • Lung Failure Conference (monthly)

The division of anatomic pathology is also host to numerous trainees from Mayo Clinic and other U.S. and international medical centers. Visitors who stay for a month or longer deliver case presentations at the end of their stay, providing additional educational content.

At the monthly, multi-institutional Pulmonary Journal Club, pulmonary pathologists from different institutions throughout the United States and Canada review the monthly literature from 15 different journals. As a fellow, you actively participate in this activity. The Journal Club is recorded and the file is posted to the Pulmonary Pathology Society website for asynchronous engagement.

Research training

Mayo Clinic performs basic, translational, and clinicopathologic correlative research. Therefore, you have many opportunities to participate in and complete several projects in one year. Our research is typically multidisciplinary, featuring collaboration with clinicians, surgeons, radiologists, bioinformaticians, molecular biologists, and biostatisticians. 

As a fellow, you will have access to administrative, laboratory, and statistics support, as well as funding, and help from a research coordinator.

The Lung Cancer Epidemiology Project at Mayo Clinic has enrolled and followed more than 14,000 people with lung cancer with extensive clinically annotated tissue available through our Tissue Registry and Lung Specimen Registry. This epidemiology project is headed by Ping Yang, M.D., Ph.D., a molecular epidemiologist.

The Tissue Registry is our clinical biorepository, which contains all paraffin-embedded specimens removed from Mayo Clinic patients since the early 1900s and offers a wealth of lung specimens for research, both neoplastic and non-neoplastic. Tissue from across Mayo Clinic is also available for research.

One month of research is included in the curriculum and distributed through pulmonary rotations according to research requirements and needs. Additional weeks of research can be taken during electives.

Fellows are strongly encouraged to present their work at national meetings, such as the United States and Canadian Academy of Pathology (USCAP), CHEST annual meeting, the American Thoracic Society (ATS), and the Pulmonary Pathology Society.

Teaching opportunities

You will participate in the second-year medical student curriculum during your pulmonary block. Additional opportunities exist based on your interest in education (such as pathology lectures to pulmonary medicine fellows).

Evaluation

To ensure that you acquire adequate knowledge and develop the appropriate technical skills to meet program expectations, your performance is monitored carefully during the Pulmonary Pathology Fellowship. You are formally evaluated by supervising faculty members on a regular basis and meet with the program director to review these evaluations.

In addition, you regularly evaluate the faculty to confirm that your educational needs are being met.